Management Essentials

Batman, Superman and Your Practice

By Farrell “Toby” Tyson, MD, FACS

Superheroes come in all shapes and forms. Personally, I always liked Batman. He didn't have superpowers but succeeded based on his intelligence and physical abilities — not to mention a lot of cool gadgets. In running a successful practice, it would be narcissistic to think that you could do everything by yourself. Even Batman had Robin. In today's complex ophthalmology practice, it is imperative not only to be intelligent and have the latest gadgets, but to possess some superpowers of your own.

SuperVision
Superman, in addition to his great strength, had X-ray vision, allowing him to see through walls. In a practice, we are able to implement policies that allow for similar transparent supervision. The essence of transparent supervision is that every staff member can see everyone else's business. This increases efficiency as the entire staff becomes involved in the self-monitoring of the practice.

Transparent supervision can only work when all policies and procedures are clearly defined and published, allowing all employees to play on a level field. Employees are empowered by knowing all the rules and how they impact not only themselves, but the other employees. Managers may have a tendency to create unpublished sets of rules which they selectively choose at their discretion. This can lead to a demoralized staff and a large inconsistency in what is expected of each employee. Transparent policies leave no room for “pets.”

Transparent supervision becomes self-regulating. Once information becomes public knowledge, you will notice a change in your staff members: they don't want to look bad in front of their peers. Staff members now have incentive to excel in their area at the same time you are monitoring other aspects of the practice. Self-regulation also means that personal feelings are removed from the equation. Less drama and more drive lead to a smoother, more efficient practice.

Scorecards and Dashboards
A scorecard is a quick reference sheet displaying the productivity of each department. The specific drivers in each department are further illustrated with a monthly dashboard that should be posted, outlining progress toward each goal. These dashboards can be based on different benchmarking tools. A dashboard for the front desk may consist of how many rings it took to answer the phone, the no-show rate, number of recall cards sent or number of charts transferred. This information is then published for the entire practice to see. Remember, what is watched improves.

Wonder Woman not only had a magic lasso of truth — which would be good for your human resources issues — but also an invisible jet. She used her invisible jet for stealth and surprise. In a practice, transparency is used to prevent surprises and minimize damage.

While watching one of our dashboards, it became evident that our new-patient to existing-patient ratio had increased. At first glance, you would think this was good news and that our practice was growing. But on further inspection, we noticed that our number of visits per month was flat and our number of recall cards mailed out was significantly down. Without the dashboards in place, this scenario might have gone unnoticed for several months, to the practice's detriment.

Sidekicks
Several superheroes partnered with sidekicks — Batman had Robin and the Green Hornet had Kato. These superheroes understood that they could not do it all on their own. In an ophthalmology practice, you need to enlist the cooperation of a core group of leaders. This core needs to assist in developing the practice goals based upon a careful assessment of where the practice is. The evaluation should take into account the budget, the fixed assets list, customer service plan and SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. Practice leaders or managers should be available to help you implement your goals and objectives, which are then tracked via benchmarking, scorecards and dashboards. With transparency among the staff, it will become clear that there is no hidden agenda.

It takes time, effort and the desire to improve that makes the difference between a standard practice and a super one. OM

Farrell C. Tyson, MD, FACS, is a refractive cataract/glaucoma eye surgeon at the Cape Coral Eye Center in Florida. He may be reached at tysonfc@hotmail.com.